DESCRIPTION (Adapted from applicant's description): The aim of this proposal is to meet the following objectives: I) Extend three active projects from the current phase I of the NIH-DC initiative which include: a) evaluating the NICU outcome measures by comparing pre- and post-intervention severity and case mix adjusted outcomes and design interventions to institutional and care practices; b) measuring and comparing interventions targeted to environmental and behavioral approaches to preterm injuries in infants; and c) enhancing and expanding the intervention to prevent adolescent pregnancy. II) These investigators propose three additional projects, as follows: a) Develop a specialized clinic for adolescent mothers and their infants combined with community linkages as an intervention targeted to improve outcome and prevent second adolescent pregnancies; b) Case management intervention strategy for biological and psychosocial high risk neonates; and c) A community based and focus group intervention for smoking cessation and reduction of preterm and at-risk pregnancy outcomes.